Helga Hanks

Infants who fail to thrive: An intervention for poor feeding practices

Abstract Although failure to thrive in the absence of organic cause was originally regarded as an outcome of emotional deprivation, the consensus among practioners now is that it results directly from inadequate nutrition, though the causes of poor feeding practices may well have origins in psychological difficulties of the parents and/or the child. An intervention of a scale which could be provided in a community setting was devised and applied to six mothers whose children were non-organically failing to thrive. The intervention was designed to enable the mothers to provide their child with adequate nutrition and resulted in a significant improvement on all measures after the very short treatment programme.

On learning from the patience

Working with families, especially in areas such as child abuse, throws up many situations that can be viewed as crises requiring urgent action. The sense of urgency can increase when attempts to protect children are met with denial and obstruction. In reviewing our experiences over more than 30 years we have come to recognize that being organized by this sense of crisis can be counterproductive. An alternative has been the counterintuitive reaction of slowing down the process and valuing the chance to consider alternatives while maintaining a steady perseverance. In other words, of patience. We consider the influences, especially from systemic therapy and attachment research that have helped us deal patiently with denial and the potentially frustrating behaviour of abused children that is an outcome of their adaptations to prolonged maltreatment. The article concludes by proposing the value of patience as a useful stance in relation to current developments in family therapy.

Countertransference in systems thinking and practice

Abstract This paper examines the psychoanalytic concept of countertransference in relation to systemic family therapy. Using clinical examples from their practice at the Leeds Family Therapy and Research Centre, the authors demonstrate how they have been able to make creative use of their own countertransference reactions in their work with families. Contrary to the tendency within much of family therapy to treat psychoanalytic concepts as redundant, the authors aim at a fuller integration of psychodynamic and systemic models by proposing a constructivist account of countertransference

Self-abuse and suicide

Abstract This brief paper can only highlight various forms of self-destructive and suicidal behaviour exhibited by children and adolescents. Clinical descriptions and research are not yet extensive enough to formulate a clear understanding of the problem. 12 The child who harms himself should be able to expect that his family doctor, accident department, or paediatrician, will consider what this behaviour might mean. In some hospitals such children are automatically admitted however serious their medical conditions so that an assessment of emotional and social aspects can be made. 9 It may be that a rapid response is essential in order to emphasise the seriousness of the selfharming behaviour and to engage the child and family most effectively. The various signs of self harm are all serious and need urgent attention when they are present in children but currently they receive this all too rarely.